This four-year project seeks to equip a clinician-scientist with a significant expertise in knowledge management (KM) and clinical decision support (CDS) with training and mentoring in health services research. This proposal aims at preparing the applicant to pursue a career as an independent investigator developing and evaluating KM and CDS interventions aimed at improving the quality, safety, efficiency, and effectiveness of health care in the U.S. and abroad. The candidate is an Assistant Professor of clinical informatics at Duke University with an M.D. degree and a Ph.D. in biomedical informatics. The candidate is the architect of a corporate-wide clinical knowledge delivery infrastructure and the author of an international knowledge delivery standard. The candidate will be mentored by a group of established investigators headed by Dr. Eric Peterson, the Director of Cardiovascular Research at the Duke Clinical Research Institute. The training and research will leverage unique scientific and training resources available at Duke University. As the primary component of his career development activities, the candidate will pursue a mentored research project focused on the development, implementation, and evaluation of a prototype for a scalable and replicable knowledge delivery system. The candidate will also pursue formal training, particularly in health services research;develop expertise in health IT standards relevant to KM and CDS;and prepare manuscripts and grant applications. The goal of the proposed research is to develop, implement, and evaluate a prototype for a scalable and widely deployable knowledge delivery service ("knowledge broker") capable of automatically delivering context-specific knowledge from online resources into electronic health record (EHR) and personal health record (PHR) systems via a "knowledge dashboard." The research will be conducted in accordance with three specific aims: (i) to build a knowledge base of patients'and providers'knowledge needs;(ii) to design, develop, and evaluate the usability of a scalable, widely deployable knowledge delivery service in a laboratory setting;(iii) To conduct a mixed-method assessment of a pilot implementation of the knowledge broker in a real-world Medical Home environment. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. In addition, the proposed software component is aligned with the development of an international standard within HL7 to support the integration between knowledge resources into EHR and PHR systems. Thus, if successful, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale. The proposed research addresses a significant unsolved problem related to the large percentage of knowledge needs that are raised and not met during the course of care, potentially leading to medical errors and compromising the safety and quality of care. This project seeks to support health care decision making and patient-centered care by delivering relevant, context-specific knowledge to patients and providers. The proposed system will be developed in conjunction with an emerging international standard on the integration between online knowledge resources and electronic health records. Thus, the proposed research will provide a prototype for an approach to delivering context-specific knowledge that could potentially be replicated on a national scale and play a significant role in the overall improvement of public health.